Recently, a client told me something about herself and ended the sentence with,  “I’m sure you already knew that.”

Actually, I didn’t.

Another told me about a choice she made and commented, “But you knew I was going to do that, didn’t you?”

And while I may have had a hunch, I really didn’t know her next move.

I am not one step ahead of you, knowing more than you do about yourself, your life, and your choices.  I am not smarter than you.  And while I (sometimes) wish I were clairvoyant, alas, I am not.  I get bits of information about you from our sessions and then put things together in ways that you haven’t thought of. I create a new framework for helping you understand what you already know about yourself. And based on that framework, your choices in life — big and small — become more understandable. That’s all very different from my sitting in the chair and predicting exactly what you’re going to do or not do when you leave my office.

We all want our therapist to be a mind reader, to help get at the feelings we can’t talk about, to help pull out the stuff that hurts.  Sometimes we dive in and start asking the tough questions; other times we wait for what seems like the right time to talk about the most difficult issues.  We do this because in the end, it is judgment that sets the pace in therapy.

As the heartbreaking and horrifying story emerges from Penn State, there is little I can say that is new. For each of the nine boys who came forward there are many more who have been silenced. By the time these stories are finally reported, we never know how many actual victims there are. Pedophiles do not stop with one child; if they have access to children, they stop when they are caught. Not any sooner.

New laws need to be passed as to who is a mandated reporter of sexual abuse in children. Everyone should be a mandated reporter. The government’s “if you SEE something, SAY something,” certainly applies here. Ditto if you SENSE something — then SAY something. Sexual abuse is a form of terrorism. We must keep on saying something until something is done. The Penn State story has to help people understand that simply telling the next person up the line is not enough. Joe Paterno is right — he should have done more.

The same education that has been used to inform the public about any epidemic must be used for sexual abuse. Inform people how common it is and to be aware of symptoms in survivors. Inform people how to trust their instincts when something an adult is doing with a child seems strange: a sleepover, a shower, buying gifts. Inform people about what to look for in perpetrators. Not everyone who works with children and gives their time is there to make the world a better place. Predators create access to kids because they are predators. The pedophile priests, coaches and scout leaders go into their fields as trusted mentors, coaches, teachers and leaders, but have one overarching purpose − fulfilling their sexual desires and fantasies with children.

Though it doesn’t help the young victims in this tragic story, Penn State is now on the right track in firing, placing on leave, and accepting resignations of everyone involved. Imagine if the church had laid off Bernard Law, instead of putting him in a nice home in the Vatican; imagine if the Pope had stepped down. Imagine a world with zero tolerance for sexual abuse. Just imagine.

I believe in therapy.

I believe there is healing.

I believe in change and I believe life gets better.

I believe that the right therapist can help you navigate even the darkest times. No therapist can take erase your suffering. No therapist can bring back what you have lost. But having someone to sit with your grief and mourn with you will allow you to create a life that you want.

I believe successful therapy is about both grief and connection. It is a two person relationship. You have to know the person who is with you on your journey. You have to know that the he or she is genuine. And you have to know that you matter.

I believe that if you don’t feel your therapist sees you, if you don’t feel the therapist likes you, you’ll be replaying history—you’ll be trying to rewrite history and get something you weren’t able to get at an earlier point in your life. And you won’t get it now. It will just be another injury. So you must be believed, and you should never have to prove anything to your therapist. The therapist is on your your team. This is something you may never have had. But it’s something you can have now.

I believe the real healing is in the relationship between therapist and client, not in diagnosis, not in education, but in connection.

Some people come into my office ready to talk, but just as many are unable  to describe what drove them to therapy. 

Some people begin therapy by telling me their history. Within fifteen minutes I know the age at which their abuse started. I know who their offender was and I know much of what happened.  Some tell me they have an abuse history and we leave it until we have a relationship that feels solid enough to hold this explosive information. 

Sometimes people start working with me and make no mention of anything in their history.  They present a job dilemma or a relationship conflict and months later there may be a “do you think it matters if?”…. Or “is it relevant if?”….The elephant in the room always matters and for therapy to work, it does have to be talked about at some point in our work.

So can I tell if you’re holding back?  Can I see it inside of you?  Sometimes.  Sometimes I will mention that the client’s issues seem consistent with an abuse history. Sometimes I’ll ask and the person will “hint” at a possibility. Even then the coping mechanisms learned as a child can camouflage the situation and I won’t know for certain until I get more information.

Is the time wasted if we aren’t talking about your abuse history?  No, not at all.  I have spent several months talking about clothes, make up, hair, movies and books with many clients before we ever get close to talking about rape.  I have spent many a session talking about football and baseball with survivors of abuse before I ever know about it.  That time is NOT filler nor is it wasted.  You’re finding out who I am … if I can be trusted … if I am someone you even want to talk to … if you value my opinions. 

Likewise, I’m finding out who you are.  I’m learning how to work with you.  We’re building a relationship, a two way street that we’re walking together.  Sometimes it just takes a while to get to know your traveling partner.

Therapy often simply puts the light on.  The difference between being in a dark room and not knowing what is in there with you, and having the lights on and being able to name things.  Sometimes therapy can nurture you; give you a comforting supporting parent’s voice that you have not had and help you internalize that voice.  Sometimes it means being less alone on the journey and being seen.  Your thoughts will be clearer and you’ll know yourself better. As a result, you’ll feel stronger and more resilient.

Therapy can help you as a partner because you will have a place to talk about the things going on in your life as a couple without violating the trust of the survivor.  It will help you to depersonalize things that may have nothing to do with you and at the same time it is essential that your partner not be the identified problem and patient.  Not everything is about your partner’s abuse; therapy can help clarify that.  Because issues arise for anyone in a relationship, therapy will also give you a safe place to work on these issues.

Sexual abuse happens in silence. In contrast, traumas in functional and non- abusive families are discussed and shared.  Death, divorce, illness are validated by conversation, comfort, and just being in the open.  No one is talking about what goes on in an abusive family.  A skilled therapist can help label things for you, stop normalizing what you have been calling dysfunction and name it as abuse, help you clarify the aftermath of what you have been left with and help you understand that no matter what you have told, it could never, ever, have been your fault and that you never deserved any of it.  Therapy, just by the act of talking is an antidote for the years of silence. 

A few days ago, I received a call from someone who had been eyeing my website and mulling over the idea of therapy for a while. Gradually she described her situation, closing in from the position of a consumer making a smart shopping decision to someone in pain and clearly in need of help. After another 10 minutes of talk, she took the plunge and set up a session. A moment before we hung up she said, “Wait! What should I expect?”

And that’s a great question. A first appointment should help you decide if the therapist is someone you want to work with.  It doesn’t matter how long you are planning to be in therapy or what your presenting issue might be. The question is this: “Can the therapist help you grow?”

You’ll get your first clue the moment you walk in the door,  before any words are spoken. It’s the “vibes” you get from the therapist’s office. Is the space comfortable for you?  Safe, inviting, private and a place where you could imagine spending time sharing who you are as well as your deepest pains?  (I once did a consult in an office where the chairs were so far apart it made me wonder if this person really wanted to be close to anyone!) If you don’t feel good in the physical space, your sessions won’t feel good either.  

Assuming the space feels right to you, it all comes down to the therapist. Do you like this person?  Is he or she warm? Do you have a sense of personality?  Do you want someone who you feel warmth towards, or do you want someone more distant who does not give out any information about themselves and just focuses on you? For some people, warmth and empathy is essential; others want the therapist to be blank and unknown

Emoting aside, is the therapist encouraging? At the bottom end of the scale, one client relayed to me how a prospective therapist told her that only when she could stop being a “crybaby about her childhood” would she be “ready” for therapy.  Ouch–as if abuse is something you just stop “crying” about, like spilled milk! You should NEVER leave a consult feeling hopeless or as if the therapist doesn’t want to work with you.  And never leave feeling unsafe. Go with your gut instincts.

Finally, after the appointment you should not feel as if the therapist is pressuring you to decide if you want to sign on for more sessions.  You shouldn’t feel that the therapist is disappointed if you need time to think it over and figure out if you want to come back.  And you should NEVER leave with an uneasy feeling that if you don’t come back you are in deep emotional trouble.  

The bottom line: This is YOUR therapy, and YOU get to make the decisions!. 

You’ve finally gotten up the nerve–calling or emailing a therapist. If you’re calling, part of you is hoping the therapist WON’T be there, so you can leave a message. Emailing feels safer because you’ll only reveal the scantest of information, like “Interested in your services, can you call?” Then your phone number. (Given the issues with email security, you SHOULDN’T leave any more than that.) But how will you know if this person is the right one? Here are some general guidelines:

1. Response Time.  How quickly did a prospective therapist return your call or email? If you haven’t heard back within 72 hours, and the therapist wasn’t on vacation, he or she may not have time for you.
2. Quality of the response. How much time did the therapist spend answering your questions? Did he or she give you a sense of who they are?  Did you feel rushed with no explanation. Or does the person say something like, “I have a 2 pm client so I only have 10 minutes, but can we schedule a mutually convenient time to talk later?”
3. No pressure.  Once you have made the call it is up to you to set the appointment.  They should not be contacting you to see if you have decided if you want to set up an initial consult.  Any further contact should be initiated by you.
4. Experience.  Do they have experience in the issues you need?  Have they worked with similar issues?  How much experience is a legitimate question to ask? 

Ultimately, it comes down to chemistry– the relationship between you and the therapist. The therapist may have answered your questions in a timely way and provided the info you want. He or she may have great credentials.  But even so, you need to follow your gut about whether you want to invite the person on your journey. And if it doesn’t work out, that’s OK–don’t clobber yourself because the choice wasn’t right. Just learn from the experience and move on. You CAN find the right therapist, someone who will help you heal and grow.

1. No child asks for sex.  Children want to be children — playing with toys or playing baseball or with their friends.  If you give them a choice between kid’s activities and sex they will choose anything but sex.  But no abuser gives them a choice.
2. Children are not sexually precocious.  They don’t create a sexual situation with an adult.  No child is responsible for anything sexual with an adult.  EVER.  If they have sexual knowledge that is “precocious” it is because someone has sexualized them or exposed them to things inappropriate for children.
3. Regardless of with whom, how often, how much, or which sexual activities, a child’s world has been devastated, violated, and damaged.  They now know that the world is a dangerous  place.  And they will never be the same.
4. Teenagers do not want sex with adults.  Teenagers want to figure sex out for themselves; they want to come into their sexuality on their own time and with people of their own choosing. 
5. Sexual abuse changes normal development.  Kids who have been sexually abused know things in a way their peers do not.  They have first hand knowledge of things kids talk about.
6. It doesn’t matter if there was penetration or not.  It doesn’t matter if there is touching or not.  Kids know when they have been violated.   It is all wrong and damaging. And it impacts everything.